The Acutely Ill Child

Question 1

List causes of jaundice in a child

Answer 1

UTI
Hypothytoidism
Galactosaemia (can't metabolise sugars properly)
Breast milk jaundice
Biliary atresia (abnormal bile duct)

Question 2

List causes of vomiting in a child

Answer 2

Reflux
CMP intolerance
Pyloric stenosis
Sepsis
Duodenal atresia

Question 3

What are the most common causes of respiratory symptoms in a child?

Answer 3

Bronchiolitis
Croup
Viral URTI
Asthma
Acute tonsilitis

Question 4

What is the most common infecting organism in croup? What is the characteristic clinical sign? How is it managed?

Answer 4

Parainfluenza virus
Barking cough (narrow air column)
Steroids

Question 5

What is the most common infecting organism in bronchiolitis? What is the characteristic clinical symptom and sign? How is it managed?

Answer 5

RSV
Dry cough and high pitched expiratory wheeze
Sternocostal recession
Supportive

Question 6

What is the most common infecting organism in whooping cough? What is the characteristic clinical sign? How is it managed?

Answer 6

Pertussis
Cold and coughing fits - stops breathing
Macrolide

Question 7

What are the most common causes of GI symptoms in a child?

Answer 7

Gastroenteritis
UTI
Constipation

Question 8

What is the most common infecting organism in paediatric UTI? What are the symptoms? How is it diagnosed?

Answer 8

E.coli
Abdominal pain, polyuria, dysuria, bed wetting, fever
Urine dipstick

Question 9

How is paediatric constipation managed?

Answer 9

Laxatives
Attention to food/ drink
Toilet behaviour advice

Question 10

List differentials to be considered for fits, faints and funny turns and outline each

Answer 10

Febrile seizure (age 2-5, physiological response to fever and high body temperature - self-limiting)
Vasovagal episode (fainting and cyanosis/pallor)
Reflex anoxic seizures (after unexpected stimuli)

Question 11

What is a useful technique for diagnosing fits, faints and funny turns?

Answer 11

Ask parents to video

Question 12

What is impetigo? What is the infecting organism? How is it managed?

Answer 12

Reddish spots on the skin, often clustered around the nose and lips, turning into yellow crusts
Staph aureus
Fluclinic acid (topical antibiotics)

Question 13

What is the infecting organism in slap cheek disease?

Answer 13

Parovirus B19

Question 14

List features of scarlet fever

Answer 14

Sandpaper red rash
Strawberry tongue
Fever

Question 15

What is the infecting organism in hand, foot, mouth disease?

Answer 15

Coxsachie/ enterovirus

Question 16

What are the presenting features of measles in a child? How is it managed?

Answer 16

Fever, cough
Maculopapular rash, starts behind ear and spreads
Small white lesions on oral mucosa (koplik spots)
MMR

Question 17

List common presenting features of asthma in a child

Answer 17

Cough (worse at night/ during play)
SOB/ chest tightness
Wheeze
Atopic history
Atopic family history
Episodic, worse after triggers (pets, pollen, cold air)